The purpose of this study was to explore the role of psychological factors and psychological treatment in burning mouth syndrome (BMS) according to the cognitive behavioral model of somatoform disorder. The review of previous research about BMS indicated that emotional arousal factors such as depression and anxiety, attention to bodily sensation, illness worry, and catastrophizing have an influence on symptoms of BMS and that the treatment for these psychological factors could improve the symptoms of BMS. Future investigations are needed to explore the effect of each technique targeted to a specific psychological factor and the effect in which these techniques were combined, and to clarify the psychological factor which is unique for BMS, not for other somatoform disorders.

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Clinical researches on biofeedback in Japan have been mainly reported at the meetings of Japanese Society of Biofeedback Research(JSBR) and Japanese Society of Psychosomatic Medicine (JSPM). The former society, JSBR was launched as a small workshop in 1973. The number of researchers and reports on biofeedback increased rapidly in first decade has now turned flat. Looking back at the history, some dominant research groups should be highlighted, such as departments of psychosomatic medicine of Tokyo University, Toho University, and Kyusyu University. Biofeedback is frequently used to control muscle activity, brood pressure, and skin temperature. Above all, clinical effectiveness seemed to be established by the biofeedback treatment using electromyography. The causes of biofeedback providers reaching a plateau recently and application possibilities in the future were discussed.

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Biofeedback therapy is a treatment method based on the methodology of biofeedback. The essential aspect of biofeedback is the process by which information on the physiological states of an organism is returned to the organism itself. With the information gained through biofeedback, clients can learn to change their physiological responses, thereby improving their health and performance. Biofeedback is applied to many disorders and is effective for a range of health problems ; for example, in reducing blood pressure in hypertensives. EMG biofeedback is used to treat many disorders related to muscle activities, such as tension headache, spasmodic torticollis, mogigraphia, clenching behavior, incontinence, and constipation. Clinical studies indicate that thermal biofeedback may ease symptoms of migraine headache and Raynaud's disease. Biofeedback training on respiratory resistance was shown to be effective for reducing the resistance in asthmatics. Recently, controlled studies have shown that heart rate variability biofeedback is also effective for reducing the symptoms of asthma. Heart rate variability biofeedback is also presumed to be useful for improving the function of the autonomic nervous system. A review of the treatment of seizure disorders using EEG biofeedback showed significant seizure reduction and reductions in seizure severity. EEG biofeedback (also called neurofeedback) has emerged as one of the dominant forces in the field of biofeedback. Neurofeedback is rapidly developing into one of the clinical tools for the treatment of neurobehavioral-based disorders and other problems that have a CNS origin. The main purpose of the biofeedback for psychosomatic disease is relaxation. Biofeedback for relaxation is more effective when combined with other relaxation techniques such as autogenic training or progressive relaxation. Biofeedback adapts subjective bodily feeling to objective bodily state, and in treatment is useful for encouraging awareness of mind-body interaction.

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A typical biofeedback device consists of sensor(s), signal amplifier, signal processor, memory unit, communication unit, display, and power supply. Each element should be suitably chosen or adjusted for a specified application. Biofeedback devices are used not only in psychosomatic medicine but also in daily life, such as stress management and mental health promotion. In the paper, biofeedback devices now available in Japan were shown and briefly discussed. In Japan the market scale of biofeedback device has been small, partly because of strict legal regulations on medical equipments and materials.

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The biofeedback therapy is appropriate for many psychosomatic diseases. The physical examination must be done before beginning the biofeedback session. It is important to assess the suitableness of patients for biofeedback therapy. The efficacy of the biofeedback therapy is pointed out for several diseases. Furthermore, the biofeedback therapy enhances those effects of the autogenic training and progressive muscle relaxation. The problems of the biofeedback therapy are the high cost for the equipment and the time required for therapy.

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It is not rare that the families of the patients whose cognitive functions are deteriorated feel helpless, specially concerning their relationships. We often see the circumstances where the family members are quite close to the patient and holding his or her hands. Therefore, we speculated handholding might lead to the improvement of family's self-efficacy. To elucidate this phenomenon, we objectively evaluated the influence of handholding on the patient's autonomic nerves system. We studied the change in patients' gastric motility under the situation with or without handholding, and the change in family's self-efficacy by explaining the study result. The subjects are 13 patients under enteral nutrition including the terminal stage cancer patients whose cognitive functions are deteriorated. Gastric motility was evaluated by ultrasonography. Family's self-efficacy level was estimated using the Generalized Self-Efficacy Scale. The results are as follows : under the handholding situation, both motility index and gastric emptying rate were significantly greater compared to those without handholding. The explanation of the study result improved family's self-efficacy.

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This article reports a successful treatment of a 13-year-old school refusal male student using a school-based behavioural approach. There were two phases in the treatment. In the first phase, a school counsellor instructed his parents in basic behaviour-based psycho-education. The second phase included active paternal intervention in school attendance for the child. The approach in this regard continued for six months, and then the student was able to reattend classes on a daily basis. A six-month follow-up found that the student attended all classes in a stable condition. This study showed that behavioural psycho-education to the parents and active paternal intervention could not only block aversive behaviours effectively but also could be a means for returning the child to school.

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